无创呼吸机治疗老年COPD呼吸衰竭合并慢性心功能不全的疗效观察和临床体会

Observation on efficacy and clinical experience of noninvasive ventilator in the treatment of elderly COPD patients with respiratory failure and chronic cardiac insufficiency

目的观察无创呼吸机治疗老年慢性阻塞性肺疾病(COPD)呼吸衰竭合并慢性心功能不全的临床疗效。方法 108例老年COPD呼吸衰竭合并慢性心功能不全患者,采用随机数字表法分成对照组和观察组,各54例。对照组患者给予临床常规治疗,观察组患者在对照组基础上配合无创呼吸机治疗,比较两组患者治疗前后心率、呼吸频率及心功能指标。结果治疗前,两组患者心率、呼吸频率比较,差异无统计学意义(P>0.05);治疗后,观察组患者心率、呼吸频率分别为(86.5±7.8)、(18.9±1.5)次/min,均明显低于对照组的(93.4±9.3)、(23.2±2.8)次/min,差异具有统计学意义(P<0.05)。治疗前,两组患者B型利尿钠肽(BNP)、左心室射血分数(LVEF)比较,差异无统计学意义(P>0.05);治疗后,观察组患者BNP、LVEF明显优于对照组,差异具有统计学意义(P<0.05)。结论无创呼吸机治疗老年COPD呼吸衰竭合并慢性心功能不全的疗效显著,对改善患者心率、呼吸频率、心功能起着关键性作用,值得临床应用推广。

Objective To observe the clinical efficacy of noninvasive ventilator in the treatment of elderly chronic obstructive pulmonary disease(COPD) patients with respiratory failure and chronic cardiac insufficiency.Methods A total of 108 elderly COPD patients with respiratory failure and chronic cardiac insufficiency were divided by random number table methods into control group and observation group, with 54 cases in each group.The control group received clinical routine therapy, and the observation group received noninvasive ventilator therapy on the basis of the control group. Comparison were made on heart rate, respiratory frequency and cardiac function indexes before and after treatment. Results Before treatment, both groups had no statistically significant difference in heart rate and respiratory frequency(P>0.05). After treatment, the observation group had obviously lower heart rate and respiratory frequency respectively as(86.5±7.8) and(18.9±1.5) times/min than(93.4±9.3)and(23.2±2.8) times/min in the control group, and their difference was statistically significant(P<0.05). Before treatment, both groups had no statistically significant difference in B-type natriuretic peptide(BNP) and left ventricular ejection fraction(LVEF)(P>0.05). After treatment, the observation group had obviously better BNP and LVEF than the control group, and the difference was statistically significant(P<0.05). Conclusion Noninvasive ventilator has a significant effect on elderly COPD patients with respiratory failure and chronic cardiac insufficiency. It plays a key role in improving heart rate, respiratory rate and cardiac function, and it is worthy of clinical application and promotion.